红细胞分布宽度、血清钙及其比值与急性胰腺炎近期预后的相关性

唐丽娜; 梁明欣; 王海燕

doi:10.3969/j.issn.1671-038X.2019.08.04

红细胞分布宽度、血清钙及其比值与急性胰腺炎近期预后的相关性

- 1. 乌鲁木齐国际医院综合内科, 新疆乌鲁木齐 830000;
- 2. 新疆军区总医院北京路临床部医务处, 新疆乌鲁木齐 830011;
- 3. 新疆军区总医院北京路临床部消化内镜室, 新疆乌鲁木齐 830011

详细信息

作者简介:
唐丽娜,主治医师,本科,研究方向:消化内科

通讯作者: 王海燕,E-mail:wanghy77@163.com

中图分类号: R576

收稿日期: 2019-03-09

Relationship between red cell distribution width,serum calcium,its ratio and recent prognosis of acute pancreatitis

- 1. Department of General Internal Medicine, Urumqi International Hospital, Urumqi 830000, China;
- 2. Department of Medical, Clinical Department of Beijing Road, General Hospital of Xinjiang Military Region, Urumqi 830011, China;
- 3. Digestive Endoscopy Room, Clinical Department of Beijing Road, General Hospital of Xinjiang Military Region, Urumqi 830011, China

More Information

Corresponding author: WANG Hai-yan, E-mail: wanghy77@163.com

Received Date: 09 March 2019

摘要

摘要: [目的]探究红细胞分布宽度(red cell distribution width,RDW)、血清钙及其比值与急性胰腺炎(acute pancreatitis,AP)患者预后的相关性。[方法]选取2015年1月~2018年10月我院收治的AP患者269例,根据30 d生存情况分为死亡组和生存组,比较2组患者的一般资料、血液学指标及严重性评分间的差异,应用Logistic回归分析患者死亡的独立危险因素,应用ROC曲线对AP患者近期死亡的预测效能进行评估。[结果]纳入研究的AP患者30 d死亡率为10.04%(27/269)。死亡组患者的平均年龄高于生存组(P＜0.05),2组在性别、发病至就诊时间、BMI、诱导因素和基础疾病间,差异无统计学意义。死亡组患者的PLT、RDW、Scr、Glu、CRP、乳酸、D-二聚体、RDW/Ca²⁺以及改良Marshall评分均显著高于生存组(P＜0.05),血Ca²⁺显著低于生存组(P＜0.05)。多因素Logistic回归显示,RDW、乳酸和Marshall评分是AP患者发生死亡的独立危险因素(OR=3.904,1.060,3.224,P＜0.05),血Ca²⁺是保护因素(OR=0.008,P＜0.05)。应用RDW/Ca²⁺预测AP患者近期预后的AUC为0.915,显著高于Marshall评分、RDW、血Ca²⁺、乳酸单独预测(Z=3.256,2.764,3.553,4.621;P＜0.05)。其中,RDW/Ca²⁺的最佳截点为6.87,此时其预测AP患者近期预后的敏感性为96.30%(26/27),特异性为78.93%(191/242)。[结论]红细胞分布宽度和血清钙的比值对AP患者近期预后具有较高的预测价值。
- 急性胰腺炎 /
- 红细胞分布宽度 /
- 血清钙 /
- 近期预后
Abstract: [Objective]To explore the correlation between red cell distribution width (RDW),serum calcium and its ratio and prognosis of patients with acute pancreatitis (AP).[Methods]269 patients with acute pancreatitis admitted to hospital from January 2015 to October 2018 were selected and divided into death group and survival group according to their 30-day survival.The differences of general data,hematological indexes and severity scores between the two groups were compared.Logistic regression was used to analyze the independent risk factors of death,and ROC curve was used to evaluate the predictive effect of related indicators on the recent death of AP patients.[Results]The 30-day mortality rate of AP patients included in the study was 10.04% (27/269).The average age of the death group was higher than that of the survival group (P<0.05).There was no significant difference between the two groups in gender,onset time,BMI,inducing factors and basic diseases (P>0.05).The PLT,RDW,Scr,Glu,CRP,lactic acid,D-dimer,RDW/Ca²⁺ and modified Marshall scores of the dead group were significantly higher than those of the survival group (all P<0.05),and the blood Ca²⁺ was significantly lower than those of the survival group (P<0.05).Multivariate Logistic regression showed that RDW,lactic acid and Marshall score were independent risk factors for death in AP patients (OR=3.904,1.060,3.224,P<0.05),and blood Ca²⁺ was protective factor (OR=0.008,P<0.05).The AUC of using RDW/Ca²⁺ to predict the short-term prognosis of AP patients was 0.915,which was significantly higher than those of Marshall score,RDW,blood Ca²⁺,lactic acid alone (Z=3.256,2.764,3.553,4.621; P<0.05).The best cut-off point of RDW/Ca²⁺ was 6.87.At the time,the sensitivity and specificity of RDW/Ca²⁺ in predicting the short-term prognosis of AP patients were 96.30% (26/27) and 78.93% (191/242).[Conclusion]The ratio of erythrocyte distribution width to serum calcium has high predictive value for the short-term prognosis of patients with acute pancreatitis.
- acute pancreatitis /
- red blood cell distribution width /
- serum calcium /
- short-term prognosis

HTML全文

参考文献(15)

[1]	中华医学会消化病学分会胰腺疾病学组, 中华胰腺病杂志编辑委员会, 中华消化杂志编辑委员会.中国急性胰腺炎诊治指南 (2013年, 上海)[J].中华消化杂志, 2013, 33 (4):217-222.
[2]	van Dijk SM, Hallensleben NDL, van Santvoort HC, et al.Acute pancreatitis:recent advances through randomised trials[J].Gut, 2017, 66 (11):2024-2032.
[3]	Pluta M, Klocek T, Krzych J.Diagnostic accuracy of red blood cell distribution width in predicting in-hospital mortality in patients undergoing high-risk gastrointestinal surgery[J].Anaesthesiol Intensive Ther, 2018, 50 (4):277-282.
[4]	Lee SI, Lee SY, Choi CH, et al.Relation between changes in red blood cell distribution width after coronary artery bypass grafting and early postoperative morbidity[J].J Thorac Dis, 2018, 10 (7):4244-4254.
[5]	中华医学会外科学分会胰腺外科学组.急性胰腺炎诊治指南 (2014)[J].中华肝胆外科杂志, 2015, 21 (1):1-4.
[6]	Forsmark CE, Vege SS, Wilcox CM.Acute Pancreatitis[J].N Engl J Med, 2016, 375 (20):1972-1981.
[7]	Chen Y, Ke L, Tong Z, et al.Association between severity and the determinant-based classification, Atlanta 2012and Atlanta 1992, in acute pancreatitis:a clinical retrospective study[J].Medicine (Baltimore), 2015, 94 (13):e638.
[8]	Vasudevan S, Goswami P, Sonika U, et al.Comparison of Various Scoring Systems and Biochemical Markers in Predicting the Outcome in Acute Pancreatitis[J].Pancreas, 2018, 47 (1):65-71.
[9]	Cǎluianu EI, Alexandru DO, Mercu t, D, et al.Assessing the Degree of Severity of Acute Pancreatitis by Using Multiparameter Scores[J].Curr Health Sci J, 2017, 43 (2):127-131.
[10]	Zerem D, Zerem O, Zerem E.Role of Clinical, Biochemical, and Imaging Parameters in predicting the Severity of Acute Pancreatitis[J].Euroasian J Hepatogastroenterol, 2017, 7 (1):1-5.
[11]	Yalçn MS, Tas A, Kara B, et al.New predictor of acute necrotizing pancreatitis:Red cell distribution width[J].Adv Clin Exp Med, 2018, 27 (2):225-228.
[12]	enol K, Saylam B, Kocaay F, et al.Red cell distribution width as a predictor of mortality in acute pancreatitis[J].Am J Emerg Med, 2013, 31 (4):687-689.
[13]	Ganji A, Esmaeilzadeh A, Ghanaei O, et al.Predictive value of red blood cell distribution width for mortality in patients with acute pancreatitis:A systematic review and meta-analysis[J].Med J Islam Repub Iran, 2017, 31 (11):124.
[14]	Goyal H, Awad H, Hu ZD.Prognostic value of admission red blood cell distribution width in acute pancreatitis:a systematic review[J].Ann Transl Med, 2017, 5 (17):342.
[15]	李兆申, 杜奕奇.重症急性胰腺炎的诊疗现状和思考[J].临床肝胆病杂志, 2014, 30 (8):709-711.